This paper analyzed a 61-year-old female patient with advanced lung cancer with grade 4 neutropenia and grade 2 thrombocytopenia after 4 days of concurrent treatment with pralsetinib and fluconazole. Clinical pharmacists considered it to be caused by fluconazole aggravating pralsetinib hematologic toxicity, successively stopped pralsetinib and fluconazole, gave patients recombinant human granulocyte stimulation factor to rise the white blood cell. After the blood cell count returned to normal, the treatment by halving the dosage of pralsetinib restarted and it gradually returned to the original dose, and no adverse reactions occurred in the subsequent treatment. This case suggests that physicians and clinical pharmacists should be aware of the potential interaction between pralsetinib and fluconazole, avoid the use of Cytochrome P450 3A4 (CYP3A4) inhibitors and adjust the dosage of drugs during pralsetinib treatment.

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